Document Detail

Optimal time for predicting left ventricular remodeling after successful primary coronary angioplasty in acute myocardial infarction using serial myocardial contrast echocardiography and magnetic resonance imaging.
MedLine Citation:
PMID:  12135139     Owner:  NLM     Status:  MEDLINE    
The objective of this study was to determine the optimal time to assess microvascular integrity within the risk area for myocardial infarction in order to predict unfavorable left ventricular remodeling (LVR) after successful primary coronary angioplasty. Fifty-three patients who underwent myocardial contrast echocardiography (MCE) just before recanalization, shortly after and 1 day (Day 2) and 3 weeks after recanalization were studied. The no- and low-reflow ratio (LR ratio) was analyzed at each stage. The wall-thinning ratio within the risk area was determined using magnetic resonance imaging performed 3-4 weeks after the recanalization. Thirteen of the 53 patients showed LVR 3-8 months after recanalization. The optimal time to predict LVR was found to be Day 2 based on the receiver operating characteristic curves. The LR ratio on Day 2 (chi2=7.39, p=0.007) and the collateral circulation before recanalization (chi2=4.57, p=0.03) were chosen as independent variables for predicting LVR. Patients with greater than 0.43 in the LR ratio on Day 2 showed a lower wall-thinning ratio (58+/-19% vs 72+/-20%, p=0.05). This study shows that the optimal time to estimate the microvascular integrity for predicting LVR is 1 day after recanalization, which is neither shortly after recanalization nor during the convalescent stage.
Tadamichi Sakuma; Takenori Okada; Yasuhiko Hayashi; Masaya Otsuka; Yuukou Hirai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  66     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-23     Completed Date:  2003-06-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  685-90     Citation Subset:  IM    
Division of Cardiology, Akane Foundation Tsuchiya General Hospital, Hiroshima, Japan.
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MeSH Terms
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary
Collateral Circulation
Coronary Angiography
Echocardiography / methods*
Magnetic Resonance Imaging
Middle Aged
Myocardial Infarction / pathology*,  therapy
Prospective Studies
ROC Curve
Time Factors
Ventricular Remodeling*

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